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Trillium Health Resources

Claims Manager

Posted 2 Days Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in Location, WV
70K-94K Annually
Junior
In-Office or Remote
Hiring Remotely in Location, WV
70K-94K Annually
Junior
Lead and oversee healthcare claims processing, ensure accurate payments and reporting, research and correct claim issues, manage appeals and provider inquiries, develop procedures, and train/mentor claims staff.
The summary above was generated by AI

Pay Plan Title: Unit Manager

Working Title: Claims Manager

FLSA Status: Exempt

Posting Salary Range: $70,338 - $94,075

Office Location: Remote within North Carolina


POSTING DETAILS:


Make an Impact


Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/developmental (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.


Why Work for Us


Trillium believes that empowering others begins with supporting our team. We offer our employees:


  • A collaborative, mission-driven work environment
  • Competitive benefits and work-from-home options for most positions
  • Opportunities for professional growth in a diverse, inclusive culture


Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.


If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!


What We’re Looking For


Trillium Health Resources has a career opening for a Claims Manager to join our team! In this key leadership role, the Claims Manager oversees the accurate and efficient processing of all healthcare claims, ensuring the integrity of claim data and delivering timely reporting and analysis. The Claims Manager manages claim-related inquiries, coordinates claim appeals, and work collaboratively across multiple internal teams to resolve provider issues.


On a typical day, you might:


  • Ensure claims payment reports are generated and analyzed to determine problems. 
  • Ensure analysis, research, and corrections are completed in a timely manner to ensure provider payment. 
  • Assist in developing and maintaining claim processing procedures and ensuring these procedures are understood and followed by claims staff. 
  • Interact with the provider community to address billing issues. 
  • Train and mentor staff on claims processing duties to enhance team performance.


Employee Benefits:


Trillium knows that work/life balance is essential. That’s why we offer:


  • Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
  • Work-from-home options available for most positions
  • Health Insurance with no premium for employee coverage
  • Flexible Spending Accounts
  • 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
  • NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
  • 401k with 5% employer match and immediate vesting
  • Public Service Loan Forgiveness (PSLF) qualifying employer
  • Quarterly stipend for remote work supplies


Qualifications


Required:

  • Associate’s degree and three (3) years of experience with extensive claims filing and data reporting; OR
  • Bachelor’s degree and a minimum of one (1) year of experience with extensive claims filing and data reporting; OR
  • Equivalent combination of education/experience.
  • Must have a valid driver’s license.
  • Must reside within North Carolina.
  • Must be able to travel within catchment as required.


Preferred:

  • Advanced degree
  • Supervisory experience of two (2) or more employees
  • Physical Health claims experience 


Deadline for Application: August 13, 2026 at 11:59pm


How to Apply


To be considered, submit your application and resume through our ADP Career Center. Your resume must include:


  • Employer name, dates of service (month/year), average hours worked per week, and essential job duties
  • Education details (degree type, date awarded, institution, field of study)
  • Licensure/certification information, if applicable


After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.


Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.


Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.


#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth

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